Driven by rewards or punishments? Understanding real world social functioning in anxiety and depressive disorders

Abstract

Background

Social disconnection is prevalent in anxiety and depressive disorders and adversely impacts well-being. Prevailing treatment approaches assume social disconnection is a by-product of anxiety or depressive symptoms; however, social impairments often persist following symptom reduction. To advance understanding of why people with anxiety or depression experience social disconnection, we tested a framework in which daily social experiences were predicted from dispositional sensitivities to positive (rewarding) vs. negative (aversive) outcomes.

Method

Adults (N = 112; aged 18–55) seeking treatment for anxiety or depression completed a measure assessing approach temperament (i.e., general sensitivity to positive outcomes) and avoidance temperament (i.e., general sensitivity to negative outcomes). They subsequently received 20 ecological momentary assessment (EMA) surveys over five consecutive days measuring current social activity, perceived connectedness, loneliness, and positive and negative affect.

Results

Individuals higher in approach temperament reported greater momentary social connectedness, lower loneliness, and more frequent social interactions (medium to large effects). They also experienced greater momentary positive affect, which was associated with all real-time social outcomes (medium to large effects). Avoidance temperament overall was not associated with daily social experiences nor affect; however, in subjects with low approach temperament, higher avoidance temperament predicted greater momentary negative affect. Real-time loneliness was linked to momentary negative affect, but only when momentary positive affect was low.

Limitations

The study was correlational; thus, causal claims cannot be made.

Conclusions

Approach temperament and its associated affective states may be uniquely related to daily social experiences in anxiety and depression and could serve as targets for interventions intended to remediate social disconnection.